Extensive testing may reduce COVID-19 mortality: a lesson from northern Italy

ABSTRACT

We examined data on the progression of COVID-19 epidemics in four regions in northern Italy. Lombardy, Emilia-Romagna, and Piedmont had an extremely steeper increase in mortality with increasing number of tests performed than Veneto, which applied a policy of broader swab testing. This suggests that the strategy adopted in Veneto, similar to that in South Korea, is effective in containing COVID-19 epidemics and should be applied in other regions of Italy and countries in Europe. On February 20, 2020, a first autochthonous case of COVID-19 respiratory disease was observed in Lombardy, Italy (1), soon followed by a second patient in Veneto, which borders Lombardy. Since then, the outbreak has rapidly expanded, mostly in regions in northern Italy (2). Initially, epidemiological surveillance and strategies for swab testing were under control of regional healthcare authorities. On February 25, the Italian Ministry of Health issued more stringent testing policies for application of swabs to identify COVID-19 cases, prioritizing patients with respiratory symptoms and possible COVID-19 contacts who required hospitalization. Most regions promptly complied with these recommendations, whereas Veneto maintained its policy, implemented after the occurrence of the first cases, of extensive testing and isolation of positive cases (3). Surprisingly, the debate stemming from these different regional policies valued international more than Italian evidences (4). We aimed at assessing, using data from the first month of the Italian experience, how different policies for swab testing may impact on the initial progression of COVID-19 epidemics. Data were obtained from the reports of the Italian Department of Civil Protection, issued since February 24, which include daily number of swabs performed and deaths from COVID-19 in each region (5). We compared Lombardy, Emilia-Romagna, and Piedmont, three regions in northern Italy that closely followed the recommendations for restrictive COVID-19 testing, and Veneto, which applied a policy of broader testing (3). Conflict of interestNone declared. Funding statementNo funding.